Establishment of Joint Attention and Parental Cues in Interaction between Hearing Parents and Young Children Who are Deaf and Hard-of-Hearing: A Systematic Review and Meta-Analysis

Objectives: This study aimed to identify the differences in the establishment of joint attention in hearing parent-deaf child dyads and hearing parent-hearing child dyads and to investigate the differences in maternal verbal and nonverbal cues during free-play episodes by using a systematic review and meta-analysis. Methods: Fourteen studies that meet the inclusive criteria were selected from eight electronic databases (PubMed, Eric, CINAHL Plus, ScienceDirect, Academic search complete, Google Scholar, RISS, Kyobo Scholar). The effect size was computed using a fixed effects model. Results: In a checklist of the study quality, the selected studies had a low risk of bias, and the subjects of a considerable number of studies were hearing mothers and young children before 36 months of age. Based on a meta-analysis, the two groups had no significant difference in the success rate of joint attention, parental verbal cues, and parental nonverbal cues. Conclusion: We observed a similar success rate of joint attention between hearing parent-deaf child dyads and hearing parent-hearing child dyads. In addition, hearing parents used similar patterns in using verbal and nonverbal cues regardless of their young children’s hearing status. Our results point to important avenues for future research on how hearing parents can better accommodate their children’s hearing status by using verbal and nonverbal cues.